Only a system-wide overhaul of the NHS that invests in staff wellbeing can address the psychological ill-health crisis amongst healthcare workers, according to research led by the University of Surrey in partnership with the University of Exeter.  The research, which is funded by the National Institute for Health and Care Research (NIHR),  focussed on nurses, midwives and paramedics who are disproportionately affected by psychological ill-health, which leads to significant consequences for both individual wellbeing and patient care. 

The study found that whilst high-pressure environments, heavy workloads, and chronic staff shortages are key drivers of stress and anxiety among healthcare professionals, it is the features of the work environment, such as lone working and career stage, such as being newly qualified, that can be key. The NHS staff survey reports that almost half of all NHS staff reported feeling unwell due to work-related stress in the past year (47%), with many experiencing unrealistic time pressures and inadequate staffing levels. 

The researchers identified several key findings, including: 

• An underlying blame culture undermines staff psychological wellness by creating a toxic work environment.
• A prevalent “serve and sacrifice” culture prioritises institutional needs over individual wellbeing.
• Healthcare professionals often experience moral distress and emotional exhaustion due to the tension between upholding professional values and the realities of clinical practice.
• A more comprehensive approach is needed to address the cumulative effects of workplace stressors rather than only focus on individual-level strategies and acute stressors.
• Developing effective psychological wellbeing interventions for diverse healthcare workers is complex.  

Professor Jill Maben OBE, Professor of Health Services Research and Nursing at the University of Surrey, said: 

“ By addressing these systemic issues, the NHS will not only improve the psychological health of its workforce, but will also enhance the quality of patient care and reduce costs associated with turnover and absenteeism”. 

A series of recommendations emerged, aiming to improve staff wellbeing and create a healthier workplace culture. First and foremost, prioritising staff wellbeing is crucial. This involves addressing essential needs such as providing access to food and hydration, break rooms, staff parking (including disabled parking), and financial security. 

A holistic and collaborative approach to staff wellbeing is also recommended. By focusing on both prevention and intervention, organisations can adopt a systems-level strategy to promote and protect wellbeing effectively. 

Other key recommendations include:

• Normalising and proactively managing psychological ill-health: Recognising that psychological stress and burnout are common challenges in healthcare is essential.
• Giving equal consideration to psychological safety alongside physical safety within the healthcare workplace.
• Developing compassionate leaders for the future: Investing in leadership development fosters a compassionate and supportive work environment.
• Fostering a learning culture and encouraging open communication: Creating a psychologically safe environment where staff feel empowered to speak without fear of retribution is vital.

Professor Cath Taylor, Professor of Healthcare Workforce Organisation and Wellbeing, said: 

“We have produced a comprehensive guide to assist NHS leaders and staff in implementing our recommendations. This resource provides practical advice on how to address poor psychological wellbeing in nurses, midwives and paramedics to create a more supportive healthcare system, allowing staff to thrive and deliver excellent care for patients”. 

For more information, and to view the guide, visit: https://workforceresearchsurrey.health/projects-resources/cup2/ 

This project was supported by the NIHR HS&DR programme with grant number 129528. The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the HS&DR programme, the NIHR or the Department of Health and Social Care.

Epsom Surrey had more mental hospitals than most English counties and, at Surrey History Centre, we are justly proud of the quantity and quality of surviving records we hold. These range from the early private asylums of the late eighteenth century through to the county asylums of the nineteenth and twentieth centuries.

Many of these records were rescued by our archivists when the institutions were closed down in the 1990s, and they include the records of some of the ‘Epsom Cluster’ of hospitals. In 1896 the newly created London County Council, faced with the need to provide for huge numbers of the mentally ill, purchased the Horton Manor estate at Epsom and built five large hospitals. The Manor opened in 1899; Horton in 1902; Ewell Epileptic Colony, later St Ebba’s, in 1904; Long Grove in 1907; and West Park in 1924.

Among the extensive archive of The Manor hospital at Surrey History Centre is a wonderful collection of glass plate negatives of individual male and female patients dating back to 1899. The patients were photographed on admission to the hospital and many who recovered after treatment were often photographed again on discharge, showing a marked improvement in their demeanour.

These glass plates had been languishing in our strong rooms so, earlier this year, we started creating digital positive copies of some of the plates that are over one hundred years old. Once digitised, the images were identified by matching them to the photographic prints in the Manor Hospital patient case books. Sadly a few of the case books had not survived, so a number of images remained unidentified, but more of this later. Thanks to our volunteer, Brenda, we have now successfully digitised over 500 images which can be viewed by researchers in our searchroom. The names of the patients whose photographs have been identified are also available on our online catalogue.

This digitisation project was actually prompted by the work of the Epsom based Friends of Horton Cemetery. Their Out of Sight, Out of Mind project explores and commemorates the lives of some of the 9,000 Epsom Cluster patients buried in unmarked graves in the disused cemetery. More information about this fascinating project can be found on the Horton Cemetery website.

This has truly been a collaborative undertaking. Also working in partnership with Surrey History Centre and the Friends of Horton Cemetery is multimedia artist and medic, Dr Eric Fong. His work spans film, photography, sculpture, and installation, often exploring themes of the body, identity, and vulnerability. His moving and haunting Cyanotype Apparitions exhibition, using some of the Manor Hospital patient glass slides, won the London Independent Film Awards’ Best Experimental Short October 2024 award.

And here’s a fitting postscript: last month saw the recovery of one of the long-lost Manor Hospital patient case books, filling an important gap in the hospital’s record collection at Surrey History Centre. Discovered in an attic, this remarkable volume, spanning May 1900 to July 1901, records the medical histories of 250 women, complete with their personal details and poignant photographic portraits. And importantly, it has allowed us to identify some more of the unnamed glass plate images.

For more news from Surrey History Centre – read more here.

Image: glass plate negative of Caroline Appleton and William Smith

Surrey History Centre

Related reports:

Attic find fills gap in Epsom local asylum history

Portraits of pauper patients in Epsom’s Horton Cemetery, inspires artist

Petition to reclaim Horton Cemetery from property speculator

Silveray, the digital X-ray film company and Surrey spinout, wins coveted Institute of Physics award with a new approach to X-ray imaging 

Innovation in X-ray technology could be key to detecting cancer more accurately than ever before, says the CEO of a startup that has won this year’s Institute for Physics Business Startup Award.  

Silveray, a spinout from the University of Surrey, has invented a flexible, reusable, and cost-effective Digital X-ray Film (DXF) that is transforming industrial radiography for weld inspection. In the long term, the ground-breaking technology offers the promise of more accurate diagnostic X-ray imaging at lower radiation doses for earlier and more accurate tumour detection, leading to better patient outcomes. 

Silveray’s nanoparticle-based material for X-ray imaging is made of a semiconductor ink that is coated on to a flexible electronic backplane with pixels that captures the X-ray image. Unlike the current X-ray market status quo, Silveray’s technology enables enhancements in image quality on a physically flexible medium at a cost-effective price point. 

Dan Cathie, CEO and Co-Founder of Silveray, said: 

“The X-ray imaging sector has seen relatively few revolutionary innovations since the advent of digital imaging. Our vision at Silveray is to develop technology that disrupts this way of thinking by creating financially sustainable, reusable, physically flexible Digital X-ray Film (DXF). 

“We know there is more to be done but this award from the Institute of Physics is a recognition of the valuable potential of our technology for the industrial non-destructive test (NDT) market. Furthermore, our vision is to become game changers for mammography and other areas of X-ray imaging with our high-sensitivity, high-resolution, Digital X-ray Film invention. 

“This award comes as fantastic recognition for the team at Silveray following the close of our recent funding round, led by Northern Gritstone.” 

Silveray was founded in 2018 by Professor Ravi Silva, Director of the Advanced Technology Institute (ATI) at the University of Surrey. Since then, Silveray and the ATI have painstakingly worked on the technology that incorporates high-Z elements (heavy atoms known for their ability to absorb X-rays) into semiconductor polymer materials, creating flexible X-ray detectors that are both sensitive and adaptable to curved surfaces.  

Professor Silva said: 

“Traditional indirect conversion X-ray detectors are stiff, costly, and inherently force a trade-off between image quality, speed, and dose, but our innovation at Silveray changes that. 

“Our direct conversion technology is flexible, reusable, and closely mimics human tissue, making it perfect for medical uses like accurate diagnosis for early tumour detection. Because it doesn’t require complicated processing, this could make a real difference in improving medical X-ray imaging and radiotherapy.” 

Image: the Silveray team with the IoP award.

Dear Editor,

Thank you to Stuart Gosling for his contribution and for highlighting the important issue of transport links in relation to the new hospital development.

Has Epsom’s new MP missed the bus to a new hospital?

I completely agree that good transport connectivity is essential for the success of this project, and I want to reassure residents that we have already considered this as part of the planning process.

New transport links will be introduced once the hospital is built, and discussions around the best way to serve the site with appropriate public transport will take place as we progress along the development timeline. It’s important to note that transport infrastructure often needs to be developed alongside the new services and demands that arise from it.

I’ll be at the forefront of ensuring that the new hospital is well-served by transport, and I’m committed to ensuring that Epsom and Ewell’s needs are fully met. The process may take time, but I’m confident the results will be worth the wait.

Yours faithfully,

Helen Maguire MP

For the third year running Epsom Methodist Church (EMC) is opening its doors and running its
Warm Wednesdays programme this winter. EMC is just one of the 80 Warm Welcome spaces
across Surrey that are open to all residents free of charge and are a place you can pop in to
stay warm, get a hot drink, receive energy advice and much more!

Situated right in the heart of Epsom in Ashley Road, Epsom Methodist Church will be open from
9.30 am to 6pm every Wednesday from 6th November through to the end of March*. We will be
providing hot drinks, hot meals, free wi-fi and friendly company and conversation. Everyone
and anyone is welcome to drop in for five minutes or stay for the whole day – no booking
required.

EMC will also be providing advice on where to go for help with energy bills, benefit problems,
financial and housing issues and obtaining warm goods and emergency support. On some
Wednesdays we will be joined by advisers from Surrey Community Action who will offer help
with keeping energy bills down, dealing with energy providers and claiming benefits such as
Pension Credit.

Each Wednesday from 3.30 pm to 6pm EMC’s Warm Space will take the form of a free after
school club for parents and children. There will be games, crafts and activities before everyone
joins together to share an evening meal together. Again no booking is required.
Lead Organiser, Robert Hill, commented:

“Energy prices have gone back up this autumn and we know some households struggle to pay
their heating bills. Warm Wednesdays not only provides a place where people can stay warm
but they can also find friendship and get practical assistance to help see them through the
winter.

“Epsom Methodist Church is proud to be part of a Surrey-wide effort to support communities
and provide help for those who need it. And it is great to have the backing of the County Council
for what we are doing.

For further information contact Robert Hill on 07802 551636 or email
roberthill.home@icloud.com

Frozen shoulder, also known as adhesive capsulitis, is a painful condition that restricts movement in the shoulder joint due to adhesion and inflammation in the joint capsule. While this condition can affect anyone, it is particularly common in women aged 40 to 60, with many cases coinciding with menopause.

What Is Frozen Shoulder?

Frozen shoulder is characterised by pain and stiffness in the shoulder joint. It progresses through two main stages: the painful stage, where movement becomes uncomfortable and often disrupts sleep, and the stiffness stage, where shoulder mobility is severely restricted. The exact cause isn’t always clear, but there are certain risk factors.

The Menopause Connection

Frozen shoulder tends to occur more frequently in women, especially during menopause. Hormonal changes, particularly declining oestrogen levels, can impact connective tissues, making them more prone to inflammation and stiffness. This hormonal shift may partly explain why women in midlife are at higher risk of developing the condition.

Signs and Symptoms

Key symptoms of frozen shoulder include:

• Pain: A deep, aching pain that worsens with movement. Night pain is common.
• Stiffness: As the condition progresses, shoulder movements become more restricted, making daily activities like dressing or reaching overhead challenging.
• Limited Range of Motion: Both active and passive movements are affected.

Risk Factors for Frozen Shoulder

• Age and Gender: Women between 40 and 60, especially those going through menopause, are at higher risk.
• Diabetes: Those with diabetes are more susceptible and often experience a more prolonged course of frozen shoulder.
• Thyroid Disorders: Hypothyroidism and other thyroid issues are linked to a higher likelihood of developing frozen shoulder.
• Immobilisation: Lack of movement after an injury or surgery can trigger the condition.

Treatment and Management Options

Physiotherapy: The Gold Standard

Physiotherapy is the cornerstone and is supported by the National Institute for Health and Care Excellence (NICE). It includes a combination of manual therapy, exercise, and education to relieve symptoms and improve shoulder function.

• Manual Therapy: Techniques like joint mobilisation and stretching are used to reduce stiffness and increase mobility.
• Exercise Therapy: A personalised exercise plan can help restore shoulder movement and build strength. Early in the painful stage, exercises are gentle, with intensity increasing as the shoulder improves.
• Patient Education: Understanding frozen shoulder, its natural progression, and expected recovery time is vital. Many patients worry about the severity of their pain, especially during menopause, but education can reassure them that frozen shoulder is manageable and temporary.

Injection Therapy: Corticosteroids and Hydrodilatation

For those whose pain severely limits rehabilitation, injection therapy can be an effective complement to physiotherapy.

• Corticosteroid Injections: These are most useful in the early painful stage, providing significant pain relief and reducing inflammation. This helps patients participate more actively in physiotherapy.
• Hydrodilatation: This procedure involves injecting a saline solution, often combined with a corticosteroid, into the joint capsule to stretch it and improve mobility. It’s typically used during the stiffness phase.

Can Frozen Shoulder Be Prevented?

While not always preventable, staying active and maintaining shoulder mobility can reduce the risk of developing frozen shoulder, particularly during menopause when hormonal changes increase vulnerability. If you experience early signs of stiffness or discomfort, seeking physiotherapy promptly can prevent the condition from worsening.

Role of Menopause in Frozen Shoulder Recovery

Due to hormonal changes, women going through menopause may experience a longer recovery time. However, with early intervention, including physiotherapy and, if necessary, injection therapy, most women see significant improvements within one to three years. Managing underlying conditions like diabetes or thyroid issues can also speed up recovery.

Conclusion

Frozen shoulder is a painful and limiting condition, but with the right treatment, particularly physiotherapy, most people can regain their shoulder mobility over time. For women experiencing menopause, the added risk makes it important to be proactive in addressing early symptoms. Whether through manual therapy, tailored exercises, or injection therapy, effective treatment can help you regain shoulder function and return to your regular activities.

Ex-smoker Councillor Mark Nuti, Cabinet Member for Health and Wellbeing, and Public Health, visited the One You Surrey stop smoking service to find out how we’re supporting smokers to quit.

Around 12% of adults in Surrey smoke, and from personal experience Mark knows that it can be tough to give up smoking. When he visited Stop Smoking Advisors Lottie and Tutua from the One You Surrey Stop Smoking Service, he found that there is lots of support available to help people in Surrey make this life-changing choice.

One You Surrey offer a free quitting service, to help residents make the first step towards a healthier and smoke-free life. With access to free quitting aids, including e-cigarettes, nicotine replacement patches and gum, as well as encouragement and support to guide smokers through their quitting journey, One You Surrey are there every step of the way. One You Surrey offer a personalised service, including 1:1 sessions and online support. Whether this is someone’s first shot at quitting smoking, or whether they feel like they’ve tried it all, the advisors at One You Surrey are here to find what works. Smokers who quit with the help of a stop smoking service are 4 times more likely to quit for good, as Mark found.

Mark told us: “The benefits of quitting smoking make this challenging journey well worth it!” After just 72 hours, you will already be able to breathe better and will have more energy. Your sense of taste and smell will improve, and quitting can boost your mood and help you to feel less stressed. And you could save close to £2000 a year, enough for a holiday or towards a new car.“

Smoking Cessation Lead Tutua shared: “Last year we were able to support over 1500 people in Surrey to successfully quit smoking. I love seeing the benefits our clients gain through their time with us, from the positive financial impact of quitting right through to people being able to run around with their children or grandchildren without getting out of breath as easily.”

To find out how One You Surrey can support you, or someone you know, in your smoke-free journey, visit https://oneyousurrey.org.uk/programmes/stop-smoking/. It’s well worth it!

Epsom and St Helier University Hospitals are in need of urgent repairs, with more than £150 million required to address crumbling infrastructure, according to the latest NHS data. Epsom and Ewell MP Helen Maguire has urged the Government to prioritise investment in the upcoming Budget to tackle these issues.

The data highlights that nearly £70 million of the required repairs are classified as ‘high risk,’ meaning a failure to address them promptly could lead to serious injury and significant disruption to healthcare services. Both hospitals have been struggling with deteriorating facilities for years, with St Helier Hospital facing particularly severe challenges, such as falling ceilings and condemned buildings.

One major issue is the division of emergency care teams across both sites, a problem that the proposed specialist emergency care hospital in Sutton is intended to resolve. However, delays in funding mean that these plans have not yet come to fruition, leaving local residents reliant on facilities that are increasingly unable to meet modern healthcare needs.

Ahead of the Autumn Budget, Liberal Democrat MP Helen Maguire has renewed her call for urgent financial support to clear the backlog of repairs and ensure that the hospitals can provide safe and effective care for local communities.

“It is scandalous that people in Epsom, Ewell, Ashtead, and Leatherhead are being treated in hospitals that need millions of pounds in repairs,” said Maguire. “When someone goes to the hospital, they should expect to be treated in a building that is safe. This is the bare minimum. We need to do far better. It is now down to this Government to rescue our NHS, which is why, at the Budget, the Chancellor must urgently use any changes to the borrowing rules to invest in hospitals here in Epsom and Ewell.”

NHS Response

A spokesperson for the Epsom and St Helier University Hospitals NHS Trust acknowledged the extent of the challenges, stating: “We’ve spent £60 million in the past five years improving the facilities in our ageing hospitals, which are deteriorating faster than we can fix them. Local people deserve better, and we’re ready to build a new state-of-the-art hospital and upgrade our existing sites, but urgently need investment to make this a reality.”

The spokesperson also highlighted the outdated nature of parts of the hospital infrastructure, some of which predate the founding of the NHS. “The age of our buildings means they flood regularly, and when our lifts break down, we can’t fix them because they don’t make the parts anymore.”

Plans for the new specialist emergency care hospital in Sutton aim to address these issues by consolidating highly skilled medical teams, providing round-the-clock care. This would alleviate the strain on the existing Epsom and St Helier hospitals, which will continue to provide 85% of local services, including outpatient appointments and scans.

The Way Forward

The pressing need for investment in the local NHS infrastructure is clear, with both the MP and the hospital trust calling for urgent action. As the Budget approaches, the focus will be on whether the Government will step up and provide the necessary funds to ensure that residents of Epsom and surrounding areas receive the healthcare services they deserve in safe and modern facilities.

Local residents will be closely watching developments in the Budget announcement, hoping that long-awaited improvements to the area’s hospitals will finally become a reality.

A public meeting has been scheduled for October 17th, 2024, at the Epsom Sports Club, located next to Epsom Hospital, to discuss the future of local healthcare services. The meeting, organized by the Epsom and Ewell’s Residents’ Associations, will be centred on the evolving plans for Epsom Hospital and the broader health services in the area. The keynote speaker, James Blythe, Managing Director of the Epsom and St Helier NHS Trust, will provide an update on the trust’s long-term plans, including the new Specialist Emergency Care Hospital (SECH) in Sutton and the modernization of both Epsom and St Helier hospitals. The event will be followed by a Q&A session, allowing local residents to voice their concerns and ask questions directly to the leadership.

This meeting follows recent developments within the Epsom and St Helier NHS Trust, which is moving forward with a £500 million project to build the SECH in Sutton. This new hospital will centralize acute services such as emergency care and surgery, while 85% of other services will remain at Epsom and St Helier hospitals, ensuring local residents continue to have access to a wide range of healthcare services nearby. The new SECH, located on the Sutton Hospital site, is designed to enhance patient outcomes by co-locating with the Royal Marsden Hospital and the London Cancer Hub​.

Epsom and Ewell’s newly elected MP, Helen Maguire, has made healthcare a key priority in her first 100 days in office. Maguire has been an advocate for the new hospital in Sutton, meeting with the Epsom and St Helier NHS Trust to see that the project moves forward without delays. In a press release marking her 100th day in office, Maguire emphasized her commitment to ensuring that the SECH is built and that Epsom and St Helier hospitals are modernized to better serve the local community. She has also scheduled a meeting with Health Secretary Wes Streeting to gain more insights into the government’s broader healthcare strategy​

Maguire’s focus on healthcare comes at a time when the trust is also addressing other critical issues such as managing its financial constraints while improving patient services. Maguire attended the trust’s recent Annual Public Meeting, underscoring the importance of the SECH in addressing long-standing challenges.

Local residents are encouraged to attend the public meeting on October 17th to stay informed about the future of their healthcare services and to have their say in the discussions about these transformative plans for Epsom and its surrounding areas.

Event Details:
Topic: The Future for Epsom Hospital and Local Health Services
Date: October 17th, 2024
Time: 7:30 PM
Venue: Epsom Sports Club, next to Epsom Hospital
Speaker: James Blythe, Managing Director, Epsom and St Helier NHS Trust
Format: Presentation followed by a Q&A session with refreshments

Guildford Lido, in Stoke Park, used to be open 12 months a year from 2014, but that ended during the pandemic. This year’s summer season ended on September 15.

Nestled between Dorking and Reigate within the picturesque Surrey Hills, the Surrey Hills Activity Centre’s (SHAC) private lagoon at Buckland Park offers a 400m loop and is the perfect setting for your open water swimming and cold water training needs.

Outdoor swimming enthusiasts have called on Guildford Borough Council (GBC) and operator Freedom Leisure to reinstate all-year-round swimming in the contract when it is renewed in November.

Reaching over 1,600 signatures, a petition has said restoring the lido’s ‘off-season’ (autumn to spring) will promote health, well-being, and athletic achievement throughout the year.

“Not a financially viable model”

Councillors quizzed the Lead for Commercial Services about the lido at GBC Overview and Scrutiny Committee on September 30. Cllr James Walsh, referencing the petition, asked if a viable compromise could be made where winter swimmers can enjoy the pool without a financial loss.

“I don’t know how many of those 1,600 people would like to swim in the winter,” said Cllr Catherine Houston, Lead for Commercial Services at GBC. She told the Overview and Scrutiny Committee, on September 30, that she went down to the lido a week before it closed and there were only 12 people in the pool. “That is not a financially viable model,” Cllr Houston added.

Run at £140k loss in the summer, the lido is still able to operate because it is paired with the Spectrum centre, according to Cllr Houston. She described it as a ‘loss leader’ model: where the lido is sold at a loss to attract customers to the Spectrum.

Cllr Houston said the lido is “already not a profitable operation in the summer” but the council chooses to run it because “we all love it”. She added: “It’s such a wonderful facility and it provides a really valuable asset to the residents, visitors and beyond.”

Questions were raised about where the money is coming from for the council to invest to keep the pool open. Although there are some super keen winter swimmers, there are not the other leisure swimmers that may spend the whole day in the lido.

Cllr Walsh asked whether letting the pool out to clubs would subsidise the running costs. Officers explained that once the pool is open, the filtration and heating will be on so it is “tough” to see how many clubs and extracurricular sports groups will be needed to offset the costs. GBC would have to pay extra for the staff, heating, energy and catering arrangements.

The “grand old lady” needs upkeep

Around 91 years old, the 50m lido is a “grand old lady” in need of “tender loving care”, according to Cllr Houston. The off-season closure allows operators to have a safe area to operate the annual works without people in the pool.

Six new boilers will be installed this winter, as part of the lido’s annual maintenance season. Three pool blankets, with an accompanying structure, will also be fitted on the lido to maintain the water’s temperature.

GBC invested £2.1m into refurbishing the lido last year, including new changing rooms, improved drainage systems, environmental technologies to reduce energy and water usage, and updated poolside catering. Freedom Leisure also put in £1m towards the upgrade.

Contractual obligations

The contract renewal in November creates a new opportunity for the operator and the council to see if a new out of season activity can be put on offer.

Cllr Houston speculated Freedom Leisure might be asked to extend its opening hours by Friends of Guildford Lido. But the operator would have to look at a financial model to see if it is worth it without the extra cash input.

Operators of the lido are contracted to keep it open for 20 weeks, so the council cannot force it to stay open unless there is a big investment. “We’re in financially challenging times so we have to make tough decisions,” the Lead for Commercial Services said.

NOTE: Friends of Guildford Lido and the petitioners were contacted for comment. Neither have got back in touch.

Image courtesy SHAC